Welcome
ATTENTION: This is a beta website, the final version will look significantly different. Thanks for bearing with us while HJM is under construction! Posts can now be found here.
Close

Growth of Medicare Advantage could suppress support of Medicare for All

January 3, 2020

Topics: Quote of the Day

By Bruce Japsen
Forbes, January 1, 2020

Health insurers are expected to make it more difficult on Presidential candidates pushing single payer versions of “Medicare for All” after they added hundreds of thousands of seniors to their private Medicare Advantage plans this year.

New benefits for seniors under Medicare Advantage began Wednesday, the first day of the 2020 New Year, in what has already been a record for the number of health plans participating in a program that offers seniors the same benefits as traditional Medicare plus extras like preventative care and outpatient healthcare services.

This new Medicare Advantage enrollment comes as most Democrats running for their party’s nomination for the Presidency back off a single payer version of Medicare for All that would uproot the private insurance industry.

Given the expansions of many established health plans into new regions and an increasing number of new entrants and startups selling Medicare Advantage, enrollment for 2020 is expected to eclipse 2019’s record. Enrollment last year in Medicare Advantage plans surpassed 22 million, which is 35% of total Medicare beneficiaries and it’s expected to reach 24 million for the 2020 plan year.

And any additional enrollment for 2020 will be difficult to uproot as candidates are finding out on the Presidential campaign trail.

https://www.forbes.com…


100,000 patients could lose access to doctors at Houston Methodist hospitals due to insurance company’s contract dispute

By Syan Rhodes
Click2Houston.com, January 1, 2020

A hundred-thousand people insured by UnitedHealthcare are scrambling to find new doctors and hospitals after the insurance company and Houston Methodist Hospital could not come to terms over reimbursement rates.

The contract expired at midnight, meaning the seven Houston Methodist hospitals and its outpatient clinics are no longer in-network as of Jan. 1, 2020.

UnitedHealthcare released the following statement:

“Care at Houston Methodist Hospital is significantly more expensive than care at other top-ranked hospitals in Texas as well as some of the most prestigious hospitals in the entire country. Every time we attempted to reach a compromise during the negotiations, Methodist responded with proposals showing that it is intent on maintaining its position as one of the most expensive health systems in the country.”

Houston Methodist Hospital released the following statement:

“Houston Methodist had a contract in place with United for 21 years before they abruptly gave notice of termination a few months ago, creating confusion among our 100,000 patients insured by United. Although Houston Methodist negotiated in earnest, an agreement was not reached by the Jan. 1, 2020 deadline and now those Medicare Advantage and commercial patients must search for new doctors and new facilities.

“We are disappointed by United’s actions — but not surprised given its aggressive actions against providers across the country.”

https://www.click2houston.com…


Comment:

By Don McCanne, M.D.

It has long been the intent of the private insurance industry and many politicians and bureaucrats to privatize the traditional Medicare program. Although the transition has been slow, it has been steady with over one-third of Medicare beneficiaries now enrolled in the private Medicare Advantage plans.

On the other side, advocates of an equitable, egalitarian system of affordable, publicly financed health care for everyone have been attempting to educate the public on the indisputable advantages of the single payer model of reform, commonly called Medicare for All. Such a system would virtually eliminate the private health insurance industry.

The stakes are high. Shall we have a patient service model that guarantees everyone affordable access to all essential health care services, administered by our own public stewards, or shall we have a business model that is designed to ensure the financial success of private administrative entities through business practices that result in tens of millions of individuals being uninsured or underinsured, using policies such as erecting financial barriers to care, limiting the health benefits that would be covered, and limiting coverage of hospitals, physicians and other health care professionals to their restricted provider networks?

People are beginning to understand the difference, and that is why the majority now support the Medicare for All model. But many do not understand that the single payer model does not work when private insurers are involved. That misinformed attitude is reinforced by the heavy marketing of the private Medicare Advantage plans, along with the complicity of some in the government. With the continued growth in the enrollment in the private Medicare Advantage plans, we could reach a state in which the traditional Medicare program is shut down and Medicare for All becomes a fragmented, multi-payer market of Medicare Advantage for All.

People don’t seem to realize how nefarious these private plans have been and will continue to be. Just one hint is in the example this week wherein UnitedHealthcare is cutting off access of their Medicare Advantage and commercial patients to Houston Methodist Hospitals. We do not know the degree of shared blame that rests with Houston Methodist, but we do know that this was strictly a business decision that threw patients to the wind. And shouldn’t our system be about the patients?

The opponents of a national health program have been effective for many decades in forestalling such a development. As we see the current political rhetoric shift from Medicare for All to being able to keep the private insurance you have (a fiction), the intensity of support is diminishing. That allows the insurance industry and their supporters in Congress and the administration to continue to creep forward with the privatization of the health care financing system – to the detriment of almost all of us.

We need to greatly intensify our efforts in education and coalition and grassroots organizing on behalf of the single payer model of an improved Medicare for All. Or will your hospitals and physicians be the next to be cut from your health care coverage?

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

See All Posts
9 views

You might also be interested in...

© Health Justice Monitor
Facebook Twitter